Beyond Introspection: A Podcast About Neurodivergence & Identity

INTRO to Medication

• BeyondPodcast • Episode 7

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Harvey and Pen discuss the medications they've taken, the process of getting on meds, and some facts about how medication works in the brain.

Featuring: Pen's extensive journey with trying meds; 1 Bad Psychiatrist; A Story about Cells; Zoloft Bullies Harvey; Medication is preventative & you have nothing to prove



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Pen:

Welcome to the Beyond introspection podcast. I'm Pen.

Harvey:

And I'm Harvey.

Pen:

This is a podcast where we talk about mental health, neurodivergence, and how it impacts literally every aspect of our lives.

Harvey:

All of them.

Pen:

Just--just all of them, including the things that we put in our body. This is the episode where we talk about medication.

Harvey:

Yes, we are finally bringing you the medication episode after weeks of promising.

Pen:

Yeah, yeah. I mean, I think--I think the--the two episodes, the two - that we just uploaded was absolutely an important thing to do, especially in that timing. So I don't I--don't really feel very bad. I am excited that we finally got to this though.

Harvey:

Yes.

Pen:

I get to talk about all-- okay, three--three medications that I'm currently on. And a[n] uncertain number that I've been on before.

Harvey:

You really can't keep track of all of them?

Pen:

I mean, it started when I was 16. So it's been--it's been six years. Which is a good long time. And especially at the beginning, there were, like, a few we went through and one of them I only took for, like, one day. So you know...

Harvey:

That's wild.

Pen:

It was because I threw up that night. And--and my mom and my stepdad were like--

Harvey:

"No, heart."

Pen:

"Let's make an appointment with the psychiatrist. Because probably you shouldn't throw up." and I was like, "Well, I was supposed to take it with food. And all I ate tonight was popcorn," because we went to a Welcome to Night Vale live show. And they were like, "I mean, you still shouldn't throw up." And I was like, "I mean, that's fair."

Harvey:

I mean, yeah,

Pen:

I actually think that might have been the first time I took Lexapro. Which is funny, cause I'm on it now. And I don't throw up. So...

Harvey:

That seems good.

Pen:

Yeah, like not vomiting.

Harvey:

Yeah.

Pen:

Yeah.

Harvey:

Yeah.

Pen:

Yeah. Okay, so we're gonna talk about medicine.

Harvey:

Yeah, I was going to say like, man, I don't know if we've ever jumped into an episode like that before.

Pen:

It's been a minute since we've recorded

Harvey:

It has, it has. It's been--actually, it's probably been about a month and a half.

Pen:

Yeah. Which is a shame. I've missed recording with you.

Harvey:

Me too. I enjoy this.

Pen:

I'm coming in here with a lot of--a lot of energy. Talking about pills--

Harvey:

You know, relative to the fact that both of us are very, very sleepy right now.

Pen:

Yeah, actually, we are. We actually are pretty tired. But my tired energy sometimes flips back and forth between the amphetamine salts that are just going through my bloodstream. Sometimes Pen just gets really chatty and energized for for a little bit.

Harvey:

A little while.

Pen:

Just a little while.

Harvey:

[Whispering] It's the speed.

Pen:

Yeah. It's the Adderall XR 20 milligrams.

Harvey:

Okay, so, this is the medication episode.

Pen:

It sure is.

Harvey:

How shall we begin our discussion of medication?

Pen:

Uh, so I think--I think useful things to talk about would probably be like, what meds we are on and our experience, like, starting to go on meds, and, like, the decisions that went into that. And then our experiences, maybe with the doctors who have given it. Things like that?

Harvey:

Yeah, you definitely have a more varied experience than I do. And you've also seen a real actual psychiatrist. So...

Pen:

I've seen three--four different ones at this point.

Harvey:

So if you'd like to kick us off.

Pen:

Okay, okay, cool. I know that I have a lot to say. And so I don't want to, like, overtake all of it. So the first psychiatrist I ever saw I was--I was 16, like I said. And I'd been in therapy, I think, for about a year. And I've talked about this before, like, I more or less put myself in therapy, because oh, my God, I was depressed. I was doing so badly. And Charlie was like, "Hey, let's--hey, let's--let's pull in your mom to have a therapy session with her as well. And we can talk about like, I think maybe you would benefit from medication," and my mom was really, really, really, really, really wicked hesitant to put me on meds.

Harvey:

Man, I would have never had a conversation with my mom like that when I was 16. So hey, kudos to you. Oh,

Pen:

I didn't want to, low-key.

Harvey:

Well, I'm sure, but, like, you did it. I just would have said to my therapist. No, no, no, heart.

Pen:

Uh, social anxiety makes that really hard. So, like, I kind of sat on the couch and, like, put my head back and like cried a little bit during it because I was so anxious. And I really wanted to be on meds because I knew that I just straight wasn't okay, and that I was at a limit of what I could do about that. But my mom was very, very concerned about some of the possible side effects and the way this--that it can hurt you. Which, understandable, but also like--like we've talked about before, sometimes your brain just can't just do things. Like it's--we just can't do it. Which I don't love but, like, punching myself over it doesn't do anything either.

Harvey:

Right. Yeah, I mean, no--no amount of, like, self-defeatist attitude is going to make my brain make enough serotonin.

Pen:

Yep, My brain just straight doesn't do some things. I would love it if it did do them. Do you know how convenient would be to maybe not have a heart rate over 100 on the regular?

Harvey:

Your brain just said,"Small-molecule neurotransmitters? No."

Pen:

There was a night where I had some kind of panic attack, I think. And you came up to the apartment and we sat on the couch. And you, like--

Harvey:

I, like, held you.

Pen:

Yeah, like, we, like, cuddled a little bit because I was so sad. And you just explained, like, different neurotransmitters to me, which was--which was genuinely helpful. Like, it was interesting, but it was a very funny sort of like, "Teach--tell me a story about neurotransmitters, Harvey."

Harvey:

Yeah, and like,[sniffling] "And what--And what does dopamine do?" [Laughter]

Pen:

Very reminiscent of when I was six, I would ask my mom to tell me stories about cells.

Harvey:

Well, neurotransmitters are cells, so, like, some things never change.

Pen:

Some things never change. But anyway, the first medication I went on was Prozac. Which, like, that's pretty common. If you're being medicated for depression, Prozac is like--like, people just know the name, you know? Sort of like knowing lithium for bipolar disorder. Um, and what Prozac did, and I'm not entirely sure why--I have a few different theories--but it felt like it took all of the walls that were in my head, because you know, like, depression, anxiety, that stuff, and just slammed them to the ground.

Harvey:

Take a sledgehammer, and just [smashing sound].

Pen:

Which is a very strange feeling. It's not just good. Like, there was some positive to it. But the other people in my life, like my teachers, and my mom, and things were like, concerned. They were like, "Hey, what's up? You--you're acting really different." And in retrospect, it's like, I mean, I'm acting less depressed and anxious, and that's the only way you've ever known me, so that. But also, like, I have wondered sometimes if it has--like, I don't--I think I probably don't have bipolar disorder, but I've wondered before, if it triggered a hypomanic episode. Now, I'm wondering if it might have treated the ADHD a little bit, because some antidepressants can do that. But whatever the reason, it was dramatic. And I think that was the one that then started giving me these horrid migraines. And so it was like, well, I can't take that anymore, because I don't like having migraines. That seems--that seems reasonable. And then it was just this process of like, okay, so we're going on this for, like, a month and a half, because it takes a while for antidepressants to work. And then let's try this one. And then that didn't work. So let's try this one. And then let's also put you on-- oh, I can't remember what it was. I can't remember what it was called. I should have looked it up. But it was the one where I should have been getting blood tests.

Harvey:

Oh, right.

Pen:

Cause you can develop a muscular disorder. And, at Dr. Daly with FHN, you never told me that, which is pretty messed up. It was when I switched psychiatrists that she was like,"Oh, so you've been having the blood tests." And I was like,"The what?" And she was like,"You can develop a muscle disorder. I mean, good news, I would have been able to tell from how you sat down if you had that or not. But yeah, that should happen. Has is it been working for you?" And I was like, "Not that I've noticed." And she was like, "Let's get you off of that." And I was like,"Thanks."

Harvey:

Uh, briefly. Can I--can I tell you some fun psychology facts about how antidepressants work?

Pen:

I would love that so much. Tell me a story.

Harvey:

I will tell you a story about cells, my dear. We're not a couple.

Pen:

I just--I also realized that. I was like, "Oh, no, let's--"

Harvey:

"Oh, no, yeah, let's--"

Pen:

"--get in front of that."[Unintelligible] very affectionate.

Harvey:

I date men.

Pen:

I have a partner. And it's not Harvey.

Harvey:

No, no, no, no, no. Um, but anyway, so stories about cells. So the reason why antidepressants take as long to work as they do is because they actually don't have a direct effect on serotonin production. It--they activate what's called second messengers that, through inadvertent means, like the extra production of--what's it called of proteins actually stimulates the production of serotonin, which I think you knew already.

Pen:

Chicken, red meat, beans...

Harvey:

Well, proteins and sort of the amino acid sense.

Pen:

Oh, I know, I know, I know. I'm just--I'm being--I'm being very funny, Harvey. I see. You're being a Smart Aleck. I am. I am doing that.

Harvey:

I take everything very seriously. But um, yeah, that's--that's part of why they take so long to work. And then the other fun fact is that some studies suggest that the presence of serotonin alone might not be the cause of depression. They think that it may actually be the ability to produce new neurotransmitters in the brain, which you need serotonin for.

Pen:

That's really interesting. I think that does make sense, definitely. Not that I know anything about the brain, you definitely know more than me. But just thinking about it in terms of like, all of the things that depression keeps you from doing. It seems like it makes some more sense for it not just to be this one chemical deficiency that is making all of that so complicated.

Harvey:

Yeah, based on what I read--I won't go too into this so as not to monopolize the time, of course--

Pen:

I mean, go for it, I have so many things to say in general, I don't want it to feel like, Pen has all this stuff. And Harvey, I have been on one medicine.

Harvey:

Zoloft. Um, so they did some studies. And what they found is that people who don't have depression, if you suppress the amount of serotonin their brain produces, they actually don't display depressive symptoms. So--but in people with depression, they're noticing that there's decreased neurogenesis, which is a fancy word for cell birth. In--let me think... the amygdala, which is sort of your fight-or-fli ht center, the frontal lobe, wh ch does like your decision maki

Pen:

That's the one that's messed up for me.

Harvey:

Yeah, and--and some of that is because dopamine is also very important in that, which, you know, we can get into dopamine later because it's relevant to you, but not to depression.

Pen:

[Sing-song] Attention deficit hyperactive disorder.

Harvey:

And there's another part of the brain that I'm forgetting, but there's some very core parts of-- oh, the hippocampus. And the hippocampus is involved in memory. So the thing that we're seeing is that there's decreased neurogenesis in all of these parts of the brain, which is why you see things like emotion dysregulation because you have--actually, a bigger amygdala. When you--okay, so there's another element to this that I forgot to explain. And I swear I'll wrap up soon. The HPA axis, which stands for the-- I believe, hypothalamic-adrenal-- pituitary-adrenal axis, which is--

Pen:

That seems important. Well, I know all three of those words, which is generally a sign that they are important in life.

Harvey:

And I'll break those down briefly. The hypothalamus takes in information from the outside world and interprets things as a stressor. If your hypothalamus interprets something as a stressor, it activates the pituitary gland. And the pituitary gland stimulates the adrenal glands, which are on the kidneys, and that releases a neurotransmitter called cortisol. And cortisol--

Pen:

I've heard of this one.

Harvey:

Yeah, cortisol is basically, like, your main distress hormone. When the brain is--what actually happens is, because of a lack of binding sites in the hypothalamus, there's a feedback loop. So--no, not those! Those are bad! So basically, people with depression, for one reason or another--and this is probably related to the decrease in serotonin--there's no mechanism to stop the HPA axis.

Pen:

Oh, no.

Harvey:

So what happens is that the brain is exposed to way more cortisol. So this leads to literal brain damage and because of a lack of serotonin, the brain has a lesser ability to replace those neurons that are, like, literally destroyed by cortisol.

Pen:

Oh, no, that is bad. That's very bad.

Harvey:

And because people without depression have that mechanism to stop the HPA axis, that's why you don't see--

Pen:

Even if you're suppressing the serotonin, it's like, you're not getting stuck in this feedback loop of stress, and then stress, and then stress, and then stress. So it's not getting wrecked.

Harvey:

Because the mechanism works in people without depression. It doesn't in people with.

Pen:

God I wish that were me. That is--that's genuinely very interesting. Can I try and, like, sum up to make sure that I'm understanding? And then hopefully the people who are listening who also don't know anything about brains? So, like, when you are depressed, whether or not, like, the presence of serotonin exactly like whether it's there or not, like, what serotonin does is helps your brain be able to, like, replace things and work good which is a plus, obviously.

Harvey:

Serotonin is sort of like oil in machine.

Pen:

Yeah. Yeah, yay! Yay! You want that. You want that oil. Brain oil.

Harvey:

That's just called cerebro-spinal fluid.

Pen:

And you want that.

Harvey:

Yes, that's true.

Pen:

My point stands. And then when you are when you are depressed, through - through several different series, your brain keeps producing stress hormone and just keeps looping in that and the decreased serotonin makes it harder for your brain to fix the damage caused by all this stress.

Harvey:

Yeah.

Pen:

Okay!

Harvey:

You are exactly right.

Pen:

Hey, yay. That's, that's awesome. And that's something I did know that like, yeah, depression messes with you and makes you like continuously stressed and it doesn't take like a big logic leap to understand that having an extremely high stress level hurts you like physically, mentally, emotionally. It is bad for your body. You're not supposed to always be stressed. This is not a complicated idea. No one likes feeling stressed.

Harvey:

Mm-mm.

Pen:

Uh, it- your body goes into Wow, we've done a lot. We are doing a lot. I don't want to.

Harvey:

No, no. Heart.

Pen:

No, heart. All right. That was that was very interesting. Thank you, Harvey.

Harvey:

You're very welcome.

Pen:

Thank you for the story about cells.

Harvey:

You're very welcome for the story about cells. Now get some good sleep, okay?

Pen:

I - Oh, God. I'll try.

Harvey:

But anyway, continuing with your discussion about medication?

Pen:

Yeah, yeah. So - so the first psychiatrist I had, I tried several different medications under him and, like I said -

Harvey:

And this is the one who did not do those blood tests.

Pen:

Yeah. Dr. Daly from FHN, I don't know if you're still doing things, Dr. Daly. But if you are, I hope you're much better at explaining to your patients what goes into each medication and what side effects they should look out for. Because you weren't good at that with me.

Harvey:

Stink man.

Pen:

And that's like, that's my biggest problem with him is that he wasn't communicating with me well, and -

Harvey:

And that seems like one of those things you want to be transparent about?

Pen:

Yeah, like that is that's very hard. The other three psychiatrists, I have gone to, um...the - the woman I went to right after Dr. Daly, because we just switched where we were going, she was good. Like I said, like she told me what was going on. And then she brought up the possibility of bipolar disorder. And so she put me on lamotrigine, which is - and she took me off the bad one - and lamotrigine, I'm still on it, actually, it is... Well, the thing that it is sort of primarily used for, and - or at least originally used for - is an anticonvulsant. Which I think it's so interesting how many medications especially for psychiatry are like, well, this works. Wasn't made for this.

Harvey:

I don't know, man, like

Pen:

This is seizure medication, but,

Harvey: See:

lithium.

Pen:

Yeah, yeah. She explained some - a lot of things to me because she brought up bipolar and she was like, okay, so there's several different drugs that can be used for that. One of them's lithium, which I wouldn't recommend, because it can have a lot of side effects.

Harvey:

Lithium has so many side effects.

Pen:

Yeah, but she did explain to me like, we don't know exactly why it works in the way it does. But it decreases suicidal thoughts. It's, it's often recommended for people who are very suicidal, we don't know why. And it was very, there was something very nice about having that explained to me, and also having a professional tell me that, that there was an uncertainty on something like that, it made me feel more confident with her because I knew she was going to be telling me the truth of all of it. So, so she put me on lamotrigine, which as well as being an anticonvulsant is sometimes used with bipolar or even just depression and things. like it's a mood stabilizer.

Harvey:

And that is such an interesting thing that like, it's pretty well known that anticonvulsants can also work as

Pen:

Yeah.-

Harvey:

- antidepressants, which is so strange.

Pen:

It is strange, and I don't, I don't know exactly why that is. But overall, I learned fairly recently with my latest psychiatrist that even if I don't have bipolar disorder, the lamotrigine or Lamictal depending on - I don't remember which one's the brand name because they're both so close together. Prozac is Prozac and fluoxetine. What - they're so different.

Harvey:

Yeah, fluoxetine...

Pen:

I have to know like the the generic name and the brand name for all my meds because it's like my insurance goes between which one it wants to fulfill so it can make me not pay hundreds of dollars. Which is preferable, especially Adderall, oh my god Adderall's so expensive. Stop getting high on Adderall. I'm begging you. I need this to- for my brain to do things. Anyway...

Harvey:

I don't have like a personal vested interest in this but because I care about my friend Pen, please.

Pen:

It's -

Harvey:

Just smoke some weed or something. I don't know. We might need to take that part out.

Pen:

Nah it's good. We live in Illinois. It's--it's--it's legal recreationally, if you are of age. Also, it's funny.

Harvey:

Yeah, I'm funny.

Pen:

But anyway, yeah. I'm on - I'm on Lamictal. And the really nice thing about Lamictal is the side effects for it are more or less one, and it's if you go too quickly when you're getting on it, you can develop a rash that can be life threatening.

Harvey:

Oh!

Pen:

Which is like, that can be a big one.

Harvey:

I don't think I've ever heard of a life threatening rash.

Pen:

Yeah, it's a very, very big deal. This rash, I don't know if it like can't kill you exactly. But it's definitely a hospitalized kind of thing.

Harvey:

That's so wild. Like, it's kind of conceptually funny, because the idea of like a life threatening rash is really funny. But -

Pen:

It's like, it's quite an extreme thing.

Harvey:

Yeah.

Pen:

The great news is the way to mitigate the possibility of getting this rash is literally just slowly increasing the dose, like instead of just going straight on to 100, because the range for it to be effective is like 100 to 400 milligrams. It's a massive range. I've been on this for years. And I only recently went up to 200 milligrams. And there's still range beyond that. But like, you just slowly go on, like 25 to 50 to 100. And then the risk for getting the rash like decreases dramatically to the point where you're more or less guaranteed to not get it. And that's it.

Harvey:

Wild!

Pen:

That's the only side effect.

Harvey:

That's, that's pretty sexy.

Pen:

It is. It's fantastic. Oh, my God, SSRIs can have so many side effects. And lamotrigine is just over here like, ight -

Harvey:

Zoloft bullies me.

Pen:

And like, all of them, I take Prozac, which I don't have side effects from it anymore. But when I first started taking it, though, I was also starting to take my Adderall again. So the insomnia could have been a combination. It was making me nauseous, it was like kind of uncomfortable. And a couple weeks later that passed, but there was that, my Adderall increases my heart rate, but we think my anxiety does as well.

Harvey:

That makes sense.

Pen:

Because when I stopped taking my Adderall, cuz, you know, the doctors I went to were like, Hey, your heart rate's at 120. It shouldn't be. And I was like, that's true. And they were like, it might be the Adderall. And I was like, that's fair. I don't want to not take it. But okay. And my psychiatrist, Jada Butler, who is amazing, she tells me things that - I'm going to briefly mention the third psychiatrists so people don't get confused. But the only reason I stopped seeing him was because he just happened to retire. Like, it was fine. He was at the university I was at and then retired. So I went somewhere else. And I found Jada. And she's amazing. She talks through every change we're considering. She told me all of the possible side effects, she starts me at the lowest possible dose just to make sure and be careful. She also talks, like every time she's like, are you still in therapy? Are you exercising? Are you eating well? She reminds me like, hey, when it goes into the winter months, make sure you're taking vitamin D because that can really affect a lot. She is extremely holistic. And it is such a comfort.

Harvey:

Jada Butler, if you're listening to this, you are pretty pog.

Pen:

Yeah, it's, I just I appreciate that so much to go from my first psychiatrist who didn't tell me I should be getting blood tests, to a psychiatrist who checks in every, every time we have session, which is every three months because you legally have to when you're taking a controlled substance -

Harvey:

Welp.

Pen:

Like every time she's like, are you in therapy? Are you making sure to take care of yourself physically, as well as taking your meds? And I'm like, Hey, Jada? [shuddering breath] Thanks.

Harvey:

You know, the point about controlled substances? I wonder if that's true of every controlled substance? Because technically, I'm on a controlled substance. And I go to the doctor, maybe once every, like, once every six months?

Pen:

I don't - I don't know, exactly. I know that it's like, I think it might be with Adderall, it's a controlled substance in that people like, abuse it?

Harvey:

That would make sense.

Pen:

Um, and -

Harvey:

Testosterone Cypionate is maybe not in that class.

Pen:

I think -

Harvey:

It's a controlled substance, but -

Pen:

Like it's being prescribed to me in a form that, if other people took it, they would get high off of it. If like testosterone would kill your liver, I think if you tried to do that.

Harvey:

If you tried to drink it, oh my god, yes. And most of the time, they just look at the vial and be like, Alright, what do I - What?

Pen:

How do I -

Harvey:

When do you...

Pen:

Do this... It becomes...

Harvey:

How do I take the testosterone?

Pen:

Um, but yeah, yeah, I - I have a good psychiatrist, now. I have relatively few side effects and everything. When we went off of my Adderall, the heart - the high heart rate didn't actually stop. It was maybe slightly lower, but it was still like over 100 -

Harvey:

Yeah.

Pen:

So that's when she put me on the Lexapro like, hey, your anxiety might be affecting your heart rate, kind of a lot. And I was like, that's a pretty good point, Jada. Let's try that. Let's try it. Let's - let's just try Lexapro, see what happens?

Harvey:

Yeah, alright Jada.

Pen:

And being on three medications and having pretty like non existent side effects, for the most part is quite the comfort. Because that's - I'm very, very lucky in that, and it has been worth all of this time and six years of trying different meds and going between psychiatrists who didn't tell me things and being in and out of therapy and in and out of like healthy living situations, to finally be at a point where it's like, I'm doing pretty good. The Lexapro has decreased my social anxiety...so, so like, dramatically, just from what I can feel - And the Adderall means that I get to just like, think and

Harvey:

Yeah, yeah. not have my brain get fogged up and distracted all the time. And Lexapro probably helps me regulate my emotions, I don't really want to change that, there's a pandemic.[Panicked noise]

Pen:

And so I know we're getting closer to when we when we should cut off and I feel like I've monopolized a lot of this episode, just like going on about my experience is starting to get on medications and whatnot.

Harvey:

I got to tell you a story about cells.

Pen:

And I liked that a lot! I liked that. But I yeah, I don't want to like, just - just have taken over this entire thing.

Harvey:

Sure.

Pen:

So is there anything that you would like to say?

Harvey:

Yeah. I'm on a medication, just one of them, in fact. When I say I'm on a controlled substance, I do take testosterone, but that's primarily for my transition. In a way you could consider that a mental health medication, in that, like, it's keeping me from not hating my body, but like, it's really not in the same class. It doesn't really have side effects. It's more or less just like, masculine. I kind of stink because I have testosterone running through my blood now. But anyway, I--

Pen:

I've called Harvey's testosterone "beard oil" before, because it is sort of oily and--

Harvey:

It is oil.

Pen:

--they have a beard now because of it. And they didn't like when I called it that.

Harvey:

That's because that's not what beard oil is.

Pen:

I know, but I'm really funny. I remind them to take it every week. And I almost exclusively called it juice for a long, long time to the point where I nearly forgot that it wasn't actually called juice.

Harvey:

Juice that makes your liver fail, I think is what we called it for a little bit.

Pen:

[Laughing] I sent you an edited picture of John from Cheers.

Harvey:

Yes!

Pen:

Anyway, sorry.

Harvey:

So the actual medication that I'm on for my mental illness, trademark, is Zoloft. Technically, I'm on the generic brand sertraline, which you can see where they might draw that connection. sertraline, Zoloft, like the sounds are like at least somewhat similar. It's not like... what, Prozac and fluoxetine?

Pen:

Can I low-key go off about that for just one minute?

Harvey:

Yes.

Pen:

Okay. So Prozac is fluoxetine, Lexapro is escitalopram, and Celexa is citalopram, so the [bleep]-- shoot, I'm gonna have to edit that! So the, like, the--the way that it just goes in between there it's like, this is nonsense. This is absolute nonsense. I'm--anyway.

Harvey:

Yeah, medication names are nonsense. But anyway, um, I'm on Zoloft. And the thing about Zoloft is that for a lot of people it, like, doesn't work. Like, Zoloft is, like, one of the more well-known antidepressants, I think, but most people I've talked to have been like, "Yeah, Zoloft was the first antidepressant I was ever on, and it, like, didn't work for me, actually, it made me feel worse." And Zoloft was the first medication I was on as well. Um, and it worked great. It's the only medication I've ever taken. Which is great, because that's apparently a little bit unusual when getting on--

Pen:

Yes.

Harvey:

--when getting on antidepressants. So, yeah, it works really well for my depression. I'm doing a lot better, as well as my anxiety it--

Pen:

Can confirm.

Harvey:

However, the problem is that Zoloft has a lot of side effects, and they're pretty bad. Um, I went through a spell of about two weeks where my mouth was just, like, unbearably dry. And dry mouth is something that, for some reason, comes with, like, most antidepressants. Like, one of the most common side effects of antidepressants, and really, any medication is dry mouth. So I--but it, like, comes and goes for me. So like, I'll have a couple months where I'll be fine, and then, like, for two weeks, my mouth will just be unbearably dry and no amount of water helps.

Pen:

I have a dry mouth spray that I can't take anymore because I have Invisalign that my dentist told me to get if you want to borrow that.

Harvey:

Maybe. Maybe, maybe, maybe. But! And then, the other thing that I've noticed happens, is I have really, really, really, really vivid dreams. Super vivid dreams. And the good news is that I don't have nightmares much anymore. Used to, but that was prior to--that was prior to getting on antidepressants, so glad I'm not dealing with too many of those anymore. But I have, like, really weird dreams, and they're all really vivid. There was one where John Mulaney was in my dream and he had a gun.

Pen:

I remember that! I remember you talking about that!

Harvey:

Um, I've had a lot of other really strange dreams too. I've had like several dreams and I--I don't know if she's listening to this episode of the podcast. Hi, Dr. Littauer, if you are. I have many dreams about my favorite professor who, like-- I don't know why she just happens to appear in my dreams a lot. She's not usually even the center focus; just like, I'm chilling, then suddenly, oh, wow. Dr. Littauer's here. Hi. So--

Pen:

It could definitely be worse.

Harvey:

Yeah, so my dreams are very vivid, but they're also like a bit nonsensical. So they do make for funny stories for when I wake up. Like, sometimes I just wake up and I'm like,"Hey, y'all want to hear what I dreamt about last night?"

Pen:

Hey, did y'all know John Mulaney sometimes has a gun?

Harvey:

Did you know that Dr. Littauer has been building her own motorcycle in her garage?

Pen:

Oh, that's a good one! I don't think you told me that one before!

Harvey:

I didn't.

Pen:

That's so good!

Harvey:

I forgot to mention it. That was actually a couple of nights ago that I dreamt about that one.

Pen:

I'm so happy.

Harvey:

But yeah, I mean, like-- I don't know, like, I don't have a lot to say about medication. I took one medication, it worked. And, like, now I'm doing so much better. I guess the thing that was tough about it is that, actually, I've been wanting to go on meds since I was 14. And I remember specifically being--being on the tube in London, with my mom, when I was 14. And then I said to her, you know, I think maybe I should go on meds. And my mom said something like, "You know you're gonna have to go back to therapy if you do that, right?" And I know that, probably, her saying that was well-intentioned, and also it was true, especially since I was so young. But it definitely, because I was terrified of therapy at the time, because of, like, one bad experience I had with, like, a super homophobic counselor, I was really afraid of therapy. So that deterred me from medication for almost six years. Until at some point, I called up my--the doctor, actually, who prescribes my testosterone, and I was like,"Hey, look, I--can you help me get with a psychiatrist? I need to go on meds." And she was like, "Oh, actually, I can prescribe antidepressants." And I'm like, "Lisa? Dr. Simons? You can--you can give me--you can give me the feel-good brain pills?" And she was like, "Yeah, that's not what they're called, but yeah." [Laughter] So yeah, I mean, that's kind of the beginning and end of it. So yeah, we should probably start wrapping up, like, pretty soon. So Pen, closing thoughts about medication?

Pen:

Yeah, yeah, I know I've said a lot this episode, and I'm sure we'll revisit some of it in the future. Focus more specific things than these "INTRO to..." ones.

Harvey:

Ah-ha.

Pen:

So yeah, getting on meds is not super simple. It can be very complicated for people. And that's perfectly okay. It is putting a foreign substance in your body, and it's understandable that could be scary. And like we've said, like, some side effects can be pretty unpleasant. That said, there's absolutely nothing shameful about the concept at all. And I know that that's sometimes a thing, where you feel like, or people tell you,"Well, if you just tried harder on your own, if you just just put in this work, if you just pull yourself up by your bootstraps..." Sometimes you can't.

Harvey:

If your brain doesn't make enough serotonin, no amount of hard work and dedication is going to make your brain produce enough serotonin.

Pen:

Yeah, it's--sometimes your brain is just not working correctly. And that's not your fault. It doesn't matter what the reason is, it doesn't matter if this is, like, a depression that has developed. It's not your fault. And there's nothing wrong with going to see a doctor about it. Like, there's a lot of comparisons out there of, like, you wouldn't just keep trying to stand on a broken leg. Like, this is--you deserve to treat yourself well, and you deserve to take yourself seriously. And even though I've had a lot of mixed experiences with the process of medication, I am so, so glad that I am taking these things now because my brain works in a way I--sometimes, in some ways, didn't realize it wasn't.

Harvey:

Yeah. That's--that's one of the biggest things I've noticed about medication, is that there are so many things that I'm capable of now that never even occurred to me as possibilities. And you know, going off of the, you know, you wouldn't just walk on a broken leg. Even if it's just a sprained ankle, like, it doesn't have to be, like... you shouldn't wait to get on medication until you're falling apart at the seams like I did. I was straight up just, like, ready to die when I got on meds. It was--it was pretty bad. If you're just in pain and you feel like going on medication would ease that, like, you--you--it's okay. It doesn't have to be dire. It really--I think you should go on meds before it's dire. It's preventative.

Pen:

Definitely. Yeah, yeah, this is preventative medication. And if you have a good psychiatrist, and you might have to shop around, and that can be hard. And there can be a lot of factors going into whether or not you go to a psychiatrist. Like Demetrea mentioned on the last episode we uploaded, that Black folks have a lot of reasons not to trust doctors, including psychiatrists.

Harvey:

And speaking as a trans person. I have plenty of reasons not to trust doctors.

Pen:

Yeah. Like, I was really nervous going to Jada Butler. I was like, "Hey, I'm nonbinary, I need you to respect that." And she was like, "Well, I'll do my best." And I remember there was one time I showed up wearing green pants. And she said there was, like, some character from TV, Mr. Green-pants. And she sort of stumbled over saying that because she didn't want to misgender me with it, but she did want to tell me about Mr. Green-pants. And I was like,"Hey, that's kind of great."

Harvey:

This--see, when we talk about well-intentioned cis people, these are the kind of people that I mean. Like, people who just want to tell you about Mr. Green-pants, but it's like,"Wait, but you're not a mister. Oh-- [stammering]"

Pen:

Well, how do I-- Like, you know what? That--hey, that works. That works. You know, this is one of the most well-intentioned, non-offensive things I've ever heard.

Harvey:

Well, yeah.

Pen:

Yeah, yeah. So that's what we've got.

Harvey:

So stick around for the next few moments and we'll tell you a little bit more about how this podcast is run. Beyond Introspection is an independently run podcast by Pen Novus and Harvey LaFord. Music by Girl Lloyd. You can find us on Twitter and Instagram at B y nd podcast. Or you can email us at beyonddot, that's d-o-t, podcast@gmail.com. We publish on Buzzsprout, iTunes, Spotify, or wherever you get your podcasts. You can find the links to our social media and email in the podcast description. Got feedback for us? Feel free to reach out on social media or via email. We'd love to hear from everyone. Take care of yourselves.